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Type 2 Diabetes & Denosumab Use in Osteoporosis

Adults with osteoporosis had a lower incidence of type 2 diabetes when treated with denosumab compared with oral bisphosphonates, a population-based study shows. “This study provides evidence at a population level that denosumab may have added benefits for glucose metabolism compared with oral bisphosphonates,” the investigators conclude.

In the U.K. from 1995 through 2021, the IQVIA Medical Research primary care database was mined for adults aged 45 years or older with osteoporosis who used denomsumab or an oral bisphophonate. Based on a primary outcome of incident type 2 diabetes, the study showed: “4,301 new users of denosumab were matched on propensity score to 21,038 users of an oral bisphosphonate and followed for a mean of 2.2 years. The incidence rate of type 2 diabetes in denosumab users was 5.7 (95% confidence interval 4.3 to 7.3) per 1,000 person years and in oral bisphosphonate users was 8.3 (7.4 to 9.2) per 1,000 person years. Initiation of denosumab was associated with a reduced risk of type 2 diabetes (hazard ratio 0.68, 95% confidence interval 0.52 to 0.89). Participants with prediabetes appeared to benefit more from denosumab compared with an oral bisphosphonate (hazard ratio 0.54, 0.35 to 0.82), as did those with a body mass index ≥30 (0.65, 0.40 to 1.06).”

Source: BMJ